Anesthesia Education on Postoperative Delirium Guidelines and Consensuses for the Adult Patient

The purpose of this study was to evaluate knowledge, perceptions, and clinical practices of Certified Registered Nurse Anesthesiologists regarding postoperative delirium (POD) and to assess the impact of an educational presentation on these three domains.

This project was a single-arm quasi-experimental pre-posttest research design.

A 19-question investigator-developed pre- and post-test was constructed to assess the domains of knowledge, clinical practices, and perceptions surrounding POD guidelines. Descriptive statistics were used for pretest data analysis. The pre-post-test data analysis used descriptive and inferential statistics, specifically the χ² test, to analyze categorical data and changes in participant responses after viewing the educational presentation.

Knowledge of the impact of POD, POD risk factors, and nonpharmacological practices to prevent POD was all rated good or excellent by over 80% of participants. The lowest knowledge points were published guidelines for POD perioperative prevention and management, nonpharmacological perioperative practices to prevent or reduce POD, and screening tools for POD risk factors and detection with 65%, 60%, 65%, and 61% reporting good or excellent knowledge, respectively. Twenty-six percent of participants reported often or always educating high-risk patients about the risk of POD and 3% of participants stated their facility uses a multidisciplinary prevention guideline for POD. Maintaining normothermia was practiced often or always by 100% of participants, and processed electroencephalography (pEEG)-based intraoperative brain monitoring was used often or always by 28% of participants. Seventy-nine percent of participants avoid benzodiazepines in high-risk patients often or always. There were no statistically significant changes identified with pre-posttest analysis.

Certified Registered Nurse Anesthesiologists' reported practice is relatively aligned with current guidelines on perioperative POD prevention and management. Some practices suggested by guidelines, such as minimizing opioids and using processed EEG monitoring to titrate anesthetic depth, had lower practice rates. Self-identified knowledge levels were moderate to high but there remains room for continued education. Pre-posttest analysis did not demonstrate statistical significance; however, participants exhibited increased knowledge and improved practice alignment with guideline-recommended practices in self-reported clinical intentions following the perioperative POD prevention and management educational intervention.